Nursing Commons^™

Critiquing Quantitative Research Reports: Key Points For The Beginner, Cathy H. Abell, Dawn M. Garrett Wright

International Journal of Faith Community Nursing

Nursing research has a long history, beginning with the first nursing researcher--Florence Nightingale. As research continues to evolve, the dissemination of findings is important. Nurses must have have an understanding of how to critically read and appraise research articles in order to assess the value of the findings.

Holistic Psychiatric Care Of Gender Dysphoric Children And Adolescents, Leah Good

Nursing Capstones

No abstract provided.

Reducing Benzodiazepine Use In The Treatment Of Anxiety In A Community Mental Health Setting, Gayle M. Mink

Graduate Theses, Dissertations, and Capstones

Abstract

Background and Significance: Anxiety Disorders affect nearly 18% of adult population annually (SAMHSA, 2013.) Per APA, (1990) & Ashton (1994), prescribers should limit use to short-term crisis or to prepare for therapy. Unintended consequences of benzodiazepines: abuse, dependence, compromised sobriety, withdrawal seizures, rebound anxiety (APA, 1990, p. 35)

Purpose of pilot: To develop/ implement an evidence based pilot program using internet-based, CBT to taper benzos with minimal/no perceived participant distress.

Theoretical Framework: The recovery model (Anthony, 1993).

Project Design: Design. Pilot project using a one-group, pre-test, post-test model.

Sample. Convenience sample of seven clients; (18 years old on long-term …

Job Satisfaction And Stress Level Of The Occupational Health Nurse, Angela Ballard

Nursing Theses and Capstone Projects

Occupational health nursing is a specialized field of nursing, employing only about 1% of total U.S. nurses (Moore & Moore, 2014). For this reason, it is often difficult to recruit prospective occupational health nurses (OHN). The need for OHN has grown in the auto industry in 2014 and 2015 due to increased production rates. It is important to determine whether or not current OHN, specifically in the auto manufacturing field, are satisfied and plan to stay in their current positions. Identifying reasons for job stress and job satisfaction helps leadership to correct deficiencies and develop and maintain a positive work …

The Correlation Between Satisfaction With Nursing Orientation And The Number Of Preceptors Utilized, Alessia H. Parker

Nursing Theses and Capstone Projects

The satisfaction of new graduate nurses with hospital orientation may impact job satisfaction, retention, and the ability of healthcare facilities to develop proficient nurses. Preceptors are an integral part of nursing orientation and the use of one or multiple preceptors during new graduate nurse orientation is discussed in previous research studies with varying results. Some study participants value using a minimal number of preceptors, while other new graduate nurses enjoy the variety of having multiple preceptors. The purpose of this thesis was to examine the effect of orienting with one or multiple preceptors on the degree of satisfaction with the …

Inpatient Diabetes Management Readiness: For The Nurse, When Does It Begin?, Lisa Haynes

Nursing Theses and Capstone Projects

It is the bedside nurse that spends the most time and effort managing symptoms of the diabetic patient during the course of a hospitalization. With the goal of optimal blood sugar levels of each patient to promote healing and wellbeing, this task can be quiet daunting. It is imperative for the acute care nurse to acquire a competency level of diabetes management that exhibits evidence-based practice, regardless of length of work experience, in order for patients to receive excellent care. This research studied the level of comfort, familiarity, and knowledge of new nurse graduates while answering the question, “When does …

The Effects Of Preoperative Education On Readmission Rates For Total Joint Arthroplasties, Michele Gobble

Nursing Theses and Capstone Projects

Background: Primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) are two of the most successful procedures performed in orthopedics. The demand for these procedures is estimated to grow 174% for THAs and 673% for TKAs by 2030, which will have a valued bill of almost $50 billion for Medicare. The bundled payment plan is a way to reduce costs for these procedures, where an estimated 35% of the bill is related to post-discharge care (Schaeffer et al., 2015, p. 723).

Review of the Literature: In 2015, this healthcare reform began including readmission penalties for patients readmitted within 30 …

The Relationship Between The Nurses’ Perception Of The Practice Environment And Patients’ Satisfaction, Shalonda Brown

Nursing Theses and Capstone Projects

Nurses’ practice environments contribute to patient satisfaction. The practice environment is influenced by work design, workforce development, organizational management practices, and culture. Each of these influential factors is significant to how patients perceive how their treatment as a person and their nursing care. The purpose of this study was to examine the nurse practice environment and determine its impact on patients’ satisfaction with care during hospitalization. The objective was to analyze the collected data and use it to gain insight and heighten awareness of how various aspects of the nurse practice environment directly and indirectly impact the patient experience. A …

Improving Transitions Of Care From Hospital To Community Provider For Patients With Type Ii Diabetes Mellitus, Laura Dale Thompson

Doctor of Nursing Practice

Poorly coordinated care transitions result in nearly half of discharged patients’ experiencing at least 1 medication error and 1 in 5 Medicare beneficiaries readmitted within 30 days. Repercussions of suboptimal transitions of care greatly impact the nation’s economy costing between $12 billion and $44 billion annually. Ineffective handoffs between providers at hospital discharge contribute to suboptimal patient outcomes; therefore, strategies to improve transitions of care are necessary to provide quality care while decreasing health care expenditure. A quality improvement project was conducted on an inpatient surgical unit to decrease hospital readmissions and emergency department visits. Proposed interventions for patients with …

Socio-Demographics And Exclusive Breastfeeding In The Medicaid/Women Infant And Children (Wic) Population In Spartanburg County, April D. Miller

Nursing Theses and Capstone Projects

Breast milk is recognized as the optimal source of nutrition for infants because of its unique nutritional and immunological characteristics. The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of an infant’s life. "Exclusive breastfeeding (EBF)" is defined as no other food or drink except breast milk for the first six months of life. Despite its countless benefits to children and mothers, the continuation rates of exclusive breastfeeding are low in the United States, especially in the Medicaid/Women Infant and Children population. It is vital to understand how multiple factors affect breastfeeding practices in order to …

Nurse Preceptors' Perceptions Of Preparedness In The Preceptor Role, Ebony Phillips

Nursing Theses and Capstone Projects

Healthcare is multifaceted with complicated illnesses that require aggressive treatments and therapies. Caring for patients with these illnesses has become progressively difficult due to the nursing shortage, high turnover rates, and lack of competence and critical thinking, which impacts quality care and outcomes. To enhance the knowledge of the nurses, preceptors are an essential part the orientation experience. Therefore, preceptors’ perceptions of preparedness influence the effectiveness of the role. Appropriate preparation provides them with the knowledge needed to meet learning needs. The aim of this study was to explore preceptors’ perceptions of preparedness in the preceptor role. The perceptions of …

The Impact Of Short Papers On Clinical Decision Making Skills Of Nursing Students, Tara R. Hayes

Nursing Theses and Capstone Projects

Clinical decision making and critical thinking are fundamental skills to ensuring the success of undergraduate nursing students. Nursing faculty, and specifically clinical nursing faculty, are responsible for encouraging the development of these types of skills as students work in direct patient care. Traditional methods of clinical evaluation include lengthy case studies, concept mapping, and discussion board participation. While these methods have been in effect for some time, clinical short paper assignments are a fresh, innovative way to challenge students as they refine their critical thinking and clinical decision making abilities. No statistically significant difference was found between the perceived level …

Depression Scores In Males And Females With Copd, Cynthia Southers

Nursing Theses and Capstone Projects

The purpose of this study was to determine the effect of participation in a pulmonary rehabilitation (PR) program on depressions scores in persons with COPD and if there is a difference between males and females in depression scores prior to and following participation in a pulmonary rehabilitation program. The literature review supported multiple factors on how participating in a pulmonary rehabilitation program can have a positive effect on depression scores. The study utilized a descriptive design with a retrospective chart review. The quantitative descriptive design identified variables and examined the differences in males and females with COPD using pre- and …

The Effects Of A Brief Mindfulness-Based Meditation Intervention On Chronic Pain, Jolena B. Allred

Nursing Theses and Capstone Projects

As the number of individuals suffering with chronic pain escalates, management is shifting from pain specialists to primary care providers. Nurse practitioners are becoming increasingly responsible for the management of this complex patient population. Analgesics, primarily opioids, have been the standard of chronic pain management with a resulting national crisis related to overuse, improper use, and illegal use of these substances. Mindfulness-based meditation has gained increasing interest and acceptance by both the individuals suffering with chronic pain and the providers managing those who suffer, however, limited investigation is available related to brief interventions provided at point-of-care. This Capstone Project evaluated …

Compassion Fatigue: Exploring The Impact On Emergency Department Nurses, Lauren E. Pittman

Nursing Theses and Capstone Projects

The purpose of this thesis project was to explore levels of compassion fatigue in emergency department nurses. Compassion fatigue has directly affected many nurses’ lives as well as impacting the field of nursing in various ways. Jean Watson’s Theory of Human Caring served as the theoretical framework for the study. The literature maintains that the prevalence of compassion fatigue has been established, yet severity varies among institutions and specialties. A quantitative study to determine the level of compassion fatigue in ED nurses was conducted by utilizing a group on the social media site Facebook that is specific to travel nurses …

Just Culture: Improve Reporting Of Near Misses And Errors In The Clinical Experience, Sharon Hart

Graduate Research Projects

No abstract provided.

Improving The Adherence Of Providers To The American Academy Of Sleep Medicine Guidelines For The Evaluation, Treatment, And Management Of Obstructive Sleep, Heather Miles

Doctor of Nursing Practice

The purpose of this project is to increase the adherence of clinic providers to the American Academy of Sleep Medicine’s Clinical Guidelines for the Evaluation, Management, and Longterm Care of Obstructive Sleep Apnea in Adults. OSA is a chronic condition that effects from 2% to 10% of the U.S. adult population. Implications of undiagnosed OSA include excessive daytime sleepiness, fatigue, irritability, difficulty controlling chronic diseases including diabetes and hypertension, heart arrhythmias, gastroesophageal reflux disease, mood disorders, attention deficit disorder, and an increased potential for dementia if left untreated. A protocol was created to align providers with the clinical guidelines. Provider …

In The Postoperative Cardiothoracic Surgical Patient Being Mechanically Ventilated, Is There A Difference In Outcomes When Comparing Sedation With Dexmedetomidine Versus Propofol?, Benjamin Heinrich Riebesel

Doctoral Projects

Patients undergoing a cardiothoracic operation typically require mechanical ventilation in the postoperative phase. Each year approximately 395,000 of these operations are performed in the United States alone. As many as 10% of these patients require reoperation within the first few hours of recovery due to complications (Barash & Cullen, 2013). This comprehensive review of the literature was performed to determine whether postoperative sedation with dexmedetomidine leads to better patient outcomes than sedation with propofol. Inclusion criteria included publications written in the English language, articles available in full text, articles written within the last 10 years, and publications with a focus …

Parturient Safety: Proper Positioning Education Prior To Neuraxial Anesthesia, Christina Joy Young

Doctoral Projects

In the United States, 61% of parturient patients elect neuraxial anesthesia for labor pain (Koyyalamudi et al., 2016). The incidence of postdural puncture headache is estimated up to 81% following accidental dural puncture-especially in pregnant women receiving elective epidurals (Ragab & Facharzt, 2014). Although the combined rates of complications for spinal and epidural anesthesia are low (2.78%) (American Society Anesthesiologists, 2014), patient safety is extremely important and should be addressed by the overall healthcare system. The purpose of this project assessed a willingness to change which focused on the CRNAs incorporation of proper positioning education prior to neuraxial anesthesia into …

The Effects Of Tranexamic Acid On Mortality Rate In Trauma Patients Compared To Trauma Patients With No Tranexamic Acid Treatment, Bradley Earl Tolar

Doctoral Projects

Traumatic injury is the leading cause of death for many age groups. Traumatic accidents caused over 130,000 deaths in the United States in 2014. This DNP project studied the effects of Tranexamic acid on mortality rate in trauma patients. After the completion of a needs assessment at a local level II trauma center, a literature review was performed. The literature showed a decrease in mortality rate when patients were administered Tranexamic acid within 3 hours of injury with statistically significant statistics. Also, the data from the literature showed no correlation between vascular occlusive events and Tranexamic acid use in trauma …

Electronic Communication Among Anesthesia Providers, Joseph K. Wells

Doctoral Projects

Facilities in the United States are utilizing electronic communication devices (ECDs) for their nursing staff on intensive care units, general medical-surgical floors, and chemotherapy floors, but it is underutilized in the operating room where seconds truly matter (Wu et al., 2012). Situations arise daily within operating rooms that require quick and decisive communication to avoid poor patient outcomes. The ultimate goal is to prevent poor patient outcomes by enhancing communication among anesthesia providers.

This doctoral project evaluated an anesthesia group in southeast Mississippi regarding their satisfaction with current devices used for communication. This anesthesia group utilized smart phones and public …

Adoption Of Perioperative Lidocaine Infusion For The Reduction Of Postoperative Pain, Brandon Scott Figueiredo

Doctoral Projects

Laparoscopic capability provides numerous benefits to patients requiring abdominal surgical procedures. However, the use of these techniques has presented the anesthesia provider with a unique set of challenges in terms of perioperative management and postoperative pain reduction. No standardized method has existed to reduce postoperative pain and improve recovery following these procedures. There were three primary goals of this project. The first goal was to conduct a meta-analysis of randomized controlled trials to determine the benefit of the use of intravenous lidocaine infusions to reduce postoperative pain in laparoscopic abdominal surgery. Twelve articles were included in the meta-analysis that pertained …

The Use Of Simulation To Decrease Stress In First Year Student Registered Nurse Anesthetists, Jared Scott Seymour

Doctoral Projects

Each year, critical care nurses across the nation make the decision to become anesthesia providers. In order to become a certified anesthesia provider, nurses must meet the high standards required to be considered for entrance into anesthesia school. Once accepted, these students, known as Student Registered Nurse Anesthetists (SRNAs), must successfully complete a rigorous curriculum consisting of both didactic and clinical training. Due in part to the high degree of difficulty of anesthesia programs, SRNAs are at risk for experiencing high levels of stress. Chipas and McKenna (2011) shows SRNAs experience a self-reported average daily stress level of 7.2 on …

Fentanyl Administration On Emergence From Surgery And Post Anesthesia Care Unit Discharge Times And Pain Scores, Andrew Ernst Wetzel

Doctoral Projects

Problem: Pain has been historically mismanaged potentially leading to a host of negative physiological consequences. Today’s dynamic health care reform offers an opportunity to increase satisfaction with care. Utilizing the PICO question, in adults undergoing laparoscopic cholecystectomy over a 12 month period, does medication with fentanyl during emergence versus not medicating during emergence reduce the need for pain medications and discharge times? Evidence/Background: Two national studies surveyed patient perception of pain management following surgery. The first, conducted by Apfelbaum et.al (2003) showed that 80% of patients experienced acute pain after surgery with 86% rating that pain as moderate …

A Comparison Of The Features And Functions Available In Electronic Health Records, Kathryn Marie Tetreault

Doctoral Projects

The Institute of Medicine (IOM) (2007) estimates that medical errors transpire at a rate of 1.5 million per year. The IOM (2000), approximates 7,000 deaths per year are related to preventable medication errors, which are the leading cause of medical errors. Adverse drug events (ADE) occur due to medication errors, which are 100% preventable. Annually, approximately $21 billion dollars are spent to care for patients’ who experience ADE due to medication errors (IOM, 2007).

This doctoral project evaluates the current features and available functions for pediatric medication administration within the electronic health record (EHR). This comparison explored the EHR functionalities …

Use Of A Handoff Communication Tool Between Certified Registered Nurse Anesthetists, Anesthesiologists, And Post Anesthesia Care Unit Nurses, Rachel Louise Johnson

Doctoral Projects

Ineffective communication in the post-anesthesia care unit (PACU) is considered to have incidences of increased error, mortality, morbidity, which leads to decrease patient outcomes and quality of care. Therefore, the purpose of this study was to introduce a structured, standardized, and consistent handoff tool to Certified Registered Nurse Anesthetists (CRNA), Anesthesiologists, and Post Anesthesia Care Unit Nurses (PACU) that may result in favorable perception of usage. Without a structured handoff tool, the organization risks the occurrence of increasing errors when the message is not transmitted effectively and efficiently every time. Distractions leave the handoff susceptible to a breakdown during the …

Regional Anesthesia Introduced Into An Emergency/Trauma, Jennifer Bryant Covalt

Doctoral Projects

Emergency rooms across the United States have an incredibly large number of shoulder dislocations that need to be manipulated and reset on a daily basis. A cost-benefit analysis in this Doctor of Nursing Practice Project will demonstrate a new form of care for shoulder dislocations in the emergency room with certified registered nurse anesthetists (CRNA) providing regional anesthesia with local lidocaine injections into the shoulder joint. A level II trauma center in Mississippi with many shoulder dislocations was the location that was used to evaluate conscious sedation, length of procedure, and pain scores. A retrospective chart review was performed at …

Older Adults Perspectives Of Bed Bathing, Nikki D. Sumner, Katherine C. Hall Phd

Undergraduate Honors Theses

The purpose of this qualitative pilot study is to explore the patient perspectives about what it is like to receive a bed bath. Examining studies of bath basins versus alternative methods has shown a decrease in the spread of nosocominal infections. However, there is not sufficient evidence evaluating the patient perspectives of assistive bed bathing and interactions with nurses and nursing support staff. This information can provide healthcare providers, especially nurses, with a better understanding of patient perspectives and values. It also supports the national healthcare approach towards patient-centered care.

The Uptake Of Skilled Birth Attendants’ Services In Rural Nepal: A Qualitative Study, Yuba Raj Baral, Jo Skinner, Edwin Van Teijlingen, Karen Lyons

Journal of Asian Midwives (JAM)

Aim and objective: The general aim of this research was to explore why women do or do not want to uptake Skilled Birth Attendants’ (SBAs) services during childbirth. The objective was to explore the factors affecting the uptake of SBAs’ services during childbirth in rural Nepal.
Methods: Semi-structured interviews were conducted. The data were analysed using thematic analysis.
Setting: The fieldwork was conducted in a rural area, in a western hill district of Nepal.
Participants: Interviews were conducted with 24 married women aged 18-49, who had given birth during the three years prior to the time of interview. Sixteen women …

Cost Analysis Of Large-Scale Implementation Of The ‘Helping Babies Breathe’ Newborn Resuscitation-Training Program In Tanzania, Sumona Chaudhury, Lauren Arlington, Shelby Brenan, Allan Kaijunga Kairuki, Amunga Robson Meda, Kahabi Isangula, Victor Mponzi, Dunstan Bishanga, Erica Thomas, Georgina Msemo, Mary Azayo, Alice Molinier, Brett D. Nelson

School of Nursing & Midwifery, East Africa

Background: Helping Babies Breathe (HBB) has become the gold standard globally for training birth-attendants in neonatal resuscitation in low-resource settings in efforts to reduce early newborn asphyxia and mortality. The purpose of this study was to do a first-ever activity-based cost-analysis of at-scale HBB program implementation and initial follow-up in a large region of Tanzania and evaluate costs of national scale-up as one component of a multi-method external evaluation of the implementation of HBB at scale in Tanzania.

Methods: We used activity-based costing to examine budget expense data during the two-month implementation and follow-up of HBB in one of the …